Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

 And just what the hell good does quantifying non-use do for getting survivors recovered? SOLVE THE FUCKING 100% RECOVERY PROBLEM instead of this useless crapola!  I'd have you all fired.

Oops, I'm not playing by the polite rules of Dale Carnegie,  'How to Win Friends and Influence People'. 

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true. 

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

The latest here:

Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life

• Marian E. Michielsen, MSc ^†
• Ruud W. Selles, PhD
• Henk J. Stam, MD, PhD
• Gerard M. Ribbers, MD, PhD
• Johannes B. Bussmann, PhD
• Show footnotes

Published:March 29, 2012DOI:https://doi.org/10.1016/j.apmr.2012.03.016

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Abstract

Michielsen ME, Selles RW, Stam HJ, Ribbers GM, Bussmann JB. Quantifying nonuse in chronic stroke patients: a study into paretic, nonparetic, and bimanual upper-limb use in daily life.

Objective

To quantify uni- and bimanual upper-limb use in patients with chronic stroke in daily life compared with healthy controls.

Design

Cross-sectional observational study.

Setting

Outpatient rehabilitation center.

Participants

Patients with chronic stroke (n=38) and healthy controls (n=18).

Intervention

Not applicable.

Main Outcome Measures

Upper-limb use in daily life was measured with an accelerometry-based upper-limb activity monitor, an accelerometer based measurement device. Unimanual use of the paretic and the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours. Outcomes were expressed in terms of both duration and intensity.

Results

Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h), while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients used their paretic side less than controls used their nondominant side and their nonparetic side more than controls their dominant side. The intensity with which patients used their paretic side was lower than that with which controls used their nondominant side, while that of the nonparetic side was higher than that of the dominant side of controls. Finally, patients used their paretic side almost exclusively in bimanual activities. During bimanual activities, the intensity with which they used their affected side was much lower than that of the nonaffected side.

Conclusion

Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during unimanual and bimanual activities in patients with chronic stroke. Patients do compensate for this with increased use of the nonparetic side.